Table 3.

Recommendations for organizers of co‐design processes

Practical recommendations	Scheduling	Participants reported half‐day workshops once a month as suitable. Longer workshop duration might have decreased participant focus
	Location	It is important that the co‐design workshops take place in a location away from participants’ workplace. This allows for protected time and neutrality for all participants. A university meeting room was deemed appropriate by all participants
	Stakeholder involvement in planning	It might be useful to involve stakeholders in the organization and preparation of workshops to ensure that any limitations due to participants’ work circumstances are adequately considered, and to limit excessive researcher input
	Participant preparation	Participant preparation in advance of meetings should be limited. Dedicated time should be allowed at workshops for participants to read essential material, rather than expecting participants to read material in advance. However, a team homework exercise was accepted by participants and perceived as beneficial by researchers, so carefully selected, relevant, volunteer preparation might be appropriate
Supporting the formation of a positive work climate	Workshop content	Workshops should include work in small and frequently changing groups to encourage participant interaction and the formation of relationships
		All workshops should include interactive exercises and movement to put participants at ease. This is particularly important during the first workshops when relationships have not yet been formed
	Informal talks	Short coffee breaks are encouraged to allow participants to network and form relationships in an informal manner.
	Attendance	Consistent attendance is essential for the formation of good working relationships. Co‐design members joining the process late should be limited/avoided unless suggested as necessary by the team to ensure appropriate representation
	Promote equality	Organizers should strive to limit any group hierarchy, for example by encouraging the use of first names rather than titles
Enhancing participant experience	Manage expectations	In order to reduce participant apprehension, organizers should make an effort to manage participants’ expectations when inviting them to take part, in order to avoid any early‐stage anxiety or apprehension. This could be achieved by explaining the co‐design process, highlighting the method's emergent nature, and emphasizing that uncertainty is a necessary and inevitable part of the process
	Review progress	Organizers should make regular updates/progress reviews, in order to make explicit the team's progress towards the goals. Lack of awareness of progress might lead to feelings of discouragement, which might adversely affect team engagement
Ensuring a genuine co‐design partnership	Allow participants to influence contents	Organizers should make sure to collect and use participant feedback to inform the direction of the co‐design process. Facilitating the collection of verbal and anonymous written feedback enables an open and honest atmosphere. Furthermore, topics raised by participants during workshops should be developed further by the organizers and followed up at subsequent workshops
	Ensure sufficient patient representation	Organizers should consider the risk of patient attrition when recruiting participants to ensure that the patient voice is sufficiently represented. Although not observed in the current study, failing to include patient representatives in sufficient numbers might negatively impact on their psychological safety and their ability to engage in an equal partnership
	Limit excessive researcher input	Organizers/researchers should be prepared to take on a more observatory role during workshops, to allow for ideas to emerge from the participants. Involving external stakeholders in the organization and preparation of workshops might help facilitate this